Exercise For The Elderly

Exercise key to successful aging

It seems an odd thing for a physician specializing in the care of the elderly to say, but Dr. Jo-Anne Clarke doesn't pay much attention to how old her patients are.

They could be 65 or 85 and she won't notice.

As a geriatrician, she is focused on their functionality and making sure it does not decline.

"Age is of no consequence to me in my clinic," said Clarke, clinical lead of North East Specialized Geriatric Services located at Pioneer Manor.

Keeping the elderly high functioning is Clarke's raison d'etre, and she oftens starts presentations with slides of people aged 90 or older who ran the London Marathon.

Clarke was guest speaker last week at the annual general meeting of the North East Community Care Access Centre.

Clarke and a team including a nurse, physiotherapist and a nurse practitioner work to prevent the development of geriatric syndrome -- a condition in which several factors such as incontinence, falls, memory loss and hearing impairment can rob older adults of their independence.

People experiencing the syndrome don't bounce back from bouts of acute illness or injury, "and there is no room for error," said Clarke.

Geriatric syndrome predisposes older adults to frailty, which Clarke described as a complex syndrome "of incredible vulnerability and inadequate response to stressors due to impairments in inter-related systems."

Clarke says many doctors who treat the frail elderly tell her: "I know frailty when I see it, but I can't define it."

About 15% of people 75 and over are frail, which means 85% are not, says Clarke.

"And we need to know that in order to manage our expectations."

What we also need to realize is that some frailty can be eliminated if modifiable, preventable steps are taken.

A disability that creeps up on the elderly, an illness and hospital stay and certainly a fall can cause the elderly to be disabled. Clarke pointed out the elderly are 59 times more likely to develop disabilities if they are hospitalized.

One of the most common causes of disability is a fall.

It takes 18 months to learn to walk, said Clarke, 18 years to become independent "and you can lose all of that in one day with a fall."

Family members often place aging relatives in long-term care after a fall out of concern for their safety. But Clarke said 30% of falls occur in the home and 50% in long-term care.

Exercise for Elderly | Exercises For Injuries

In a 10 week supervised hip flexor stretching program in frail elderly, they looked to see if the stretching program would improved:

hip extension stride length gait speed reduced anterior pelvic tilt during comfortable and fast-paced walking

They had 74 frail elderly (65 and over) individuals in the study with 41 in the control group and 33 in the stretching group.

What They Did

They had the stretching group perform a hip flexor stretching program twice a day and twice a week the program was supervised by a rehabilitation clinician.

What Kind of Hip Flexor Stretch Did they Do

They did a kneeling hip flexor stretch.

Highlights of the Study

walking speed stride length passive hip extension range of motion

After the stretching program there was no significant changes in peak hip extension or anterior pelvic tilt during comfortable and fast-paced walking.

Last Word from Rick Kaselj <==  THE PART TO READ

This is important information if you work with an order adult and you need to improve gait function (walking).

This research shows that a kneeling hip flexor stretch can help do that.

Where to Get More Information

Watt JR, Jackson K, Franz JR, Dicharry J, Evans J, Kerrigan DC. (2011). Effect of a supervised hip flexor stretching program on gait in frail elderly patients. PM R. 2011 Apr;3(4):330-5.

As I was researching the Watt 2011 study, I cam across some other studies that build on hip flexor stretching in the elderly.

Christiansen CL. (2008). The effects of hip and ankle stretching on gait function of older people. Arch Phys Med Rehabil. 2008 Aug;89(8):1421-8.

Participants participated in a 8 week stretching program and had improvements in joint motion in the hip and the ankle.

Kerrigan DC, Xenopoulos-Oddsson A, Sullivan MJ, Lelas JJ, Riley PO. (2003). Effect of a hip flexor-stretching program on gait in the elderly. Arch Phys Med Rehabil. 2003 Jan;84(1):1-6.

Unfortunately I was not able to get the Watt, 2011 full text journal but I was able to get the Kerrigan 2003 full text journal which is very similar to the Watt study.

In this study they got one group to do a hip flexor stretch and a second group to do to an arm cross shoulder stretch.

Each group did the stretch 4 times on each side, alternating and holding for 30 seconds for a total of 8 stretches.  They did this twice a day for 10 weeks.